Pemphigus in Dogs

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Pemphigus is a group of skin diseases in dogs that are caused by an autoimmune disorder. That means the dog's own immune system attacks components of the skin.

Cause of Canine Pemphigus

Pemphigus in dogs is a dysfunction of the immune system. The exact mechanism of how it develops isn't known with certainty, but somehow, cells of a dog's healthy skin are marked for destruction by the immune system.

The condition may have a genetic component. Breeds prone to it include:

• Akitas
• Bearded collies
• Chows
• Dachshunds
• Dobermans
• Newfoundlands
• German shepherds

Pemphigus may be caused by inherent problems with the immune system (genetics) or outside triggers that throw the immune system off and cause it to overreact, such as UV light exposure, a virus, or a drug reaction.

Types of Pemphigus in Dogs

There are four types of canine pemphigus:

• Foliaceus is when the most superficial layer of the epidermis is affected.
• Vulgaris is more severe, affecting deeper skin cells and resulting in worse ulcers. This type of pemphigus is often fatal.
• Erythematosus affects the superficial layer of skin and is less severe than the other forms. It usually affects only the head, face, and pads of the feet.
• Vegetans is the rarest type of pemphigus in dogs, and it affects deeper layers of the skin like vulgaris but is less severe.

Signs of Pemphigus in Dogs

Signs of pemphigus vary depending on which of the four types is affecting the dog.

Signs of pemphigus foliaceus usually affect the head, ears, and footpads but also often become generalized over the whole body and include:

• Scaling, crusting, redness, and ulcers of the skin.
• Hair loss.
• Thickening and cracking of the foot pads.
• Signs of secondary infection of the affected areas may include pustules and oozing.

Signs of pemphigus erythematosus are much the same as foliaceus, but it's more common to have a loss of skin pigment in the areas affected, and signs do not usually become generalized.

Signs of pemphigus vulgaris include:

• Ulcers, erosion, blisters, and crusting of the skin.
• This form of the condition has more severe signs than foliaceus or erythematosus.
• Commonly affects the mucous membranes inside the mouth, causing ulcers.
• Skin in the groin and armpit areas is often involved.
• Decreased appetite.
• Fever.
• Lethargy.
• Secondary bacterial infections of affected skin occur commonly.

Signs of pemphigus vulgaris include:

• White skin bumps that gather in masses and ooze.
• Does not involve the oral mucous membranes.
• Does not become a systemic illness.

Diagnosis of Canine Pemphigus

Other skin conditions that can show up with similar signs are numerous, and the veterinarian will need to consider them. Just a few conditions that must be ruled out include:

• Severe bacterial infection of the skin (secondary to allergy or other).
• Ringworm.
• Demodicosis.
• Lupus (DLE).
• Fungal infection of the skin (possibly secondary to allergy).

The veterinarian may do cytology or impression smears of the skin lesions and look at the cells under the microscope. That involves getting a sample of cells in the affected areas either by drawing them out with a needle (cytology) or firmly pressing a microscope slide into them (impression smears).

Culture and sensitivity of the skin can diagnose and help choose treatment for secondary bacterial infections.

Biopsy samples of the skin are sent away to a pathology lab for testing, and this is ultimately the way a pemphigus diagnosis is reached. The samples are studied under a microscope and have some specialized tests performed on them, including immunofluorescent antibody assays.

Tests for other conditions, such as skin scraping and fungal culture, may also be done during diagnosis.

Treatment of Pemphigus in Dogs

Severely affected dogs that aren't eating may need hospitalization for supportive care initially.

Antibiotics may be required to control secondary infections.

Corticosteroids (prednisone most frequently) are the most commonly used treatment for pemphigus in dogs. They are given on a tapering dosage for a month or more.

Some patients require other immune-suppressive drugs along with corticosteroids to control an outbreak of pemphigus. There are several of these for the veterinarian to choose from.

Some dogs need medication for life. Medication side effects must be monitored for and treated if necessary.

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